- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $7,244.36 / $14,454.40
| Facility | | $1,047.13 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $575.44 / $1,412.54
| Professional | | $478.63 | $575.44 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,417.38 / $21,379.62 / $57,543.99
| Facility | | $20,417.38 | $21,379.62 | $57,543.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $478.63 / $794.33 / $954.99
| Professional | | $478.63 | $794.33 | $954.99 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $501.19 / $676.08 / $977.24
| Professional | | $501.19 | $676.08 | $977.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $794.33
| Professional | | $707.95 | $707.95 | $794.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $537.03 / $676.08 / $977.24
| Professional | | $537.03 | $676.08 | $977.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $5,370.32 / $13,803.84
| Facility | | $831.76 | $5,370.32 | $13,803.84 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $489.78 / $630.96 / $1,513.56
| Professional | | $489.78 | $630.96 | $1,513.56 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $15.14 / $15.14 / $1,202.26
| Professional | | $15.14 | $15.14 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.74 / $478.63 / $562.34
| Facility | | $467.74 | $478.63 | $562.34 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $407.38 / $478.63 / $575.44
| Professional | | $407.38 | $478.63 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $2,570.40 / $6,760.83
| Facility | | $660.69 | $2,570.40 | $6,760.83 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $467.74 / $630.96 / $1,023.29
| Professional | | $467.74 | $630.96 | $1,023.29 |